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The Pain Dilemma

Posted Oct 09 2008 8:33am

Pain is one of the most misunderstood complaints that doctors have to face every day.  I'm not talking about the pain you feel when you trip and fall or from playing too much tennis.  I'm talking about the pain that accompanies a medical illness. 

The problem is that unlike disease that doctors can test for, there is no test for pain.  In our culture the rumor is that we are a drug seeking culture.  In twenty years of working with those facing chronic and life-threatening illness I've come across a handful of drug seeking patients, but the majority and I mean the overwhelming majority experience true pain.

So what's the problem?  The problem is that since there is no test to corroberate the pain; the doctor has to believe the patient's disclosure of pain.  It comes down to believability.  I'm not saying that's right...that's the way it is.  With certain diagnoses doctors expect pain either as a result of the disease, a certain test or the treatment itself.  We can't always predict pain so it's important that you keep a pain log and bring it in to every visit so your doctor can be aware of your pain issues.

Just as an aside.  Some doctors, especially general practitioners or internists are cautious about writing too many prescriptions for pain meds (sometimes you'll hear the word triplicates used).  Doctor's prescriptions are monitored and unless your in a specialty where pain is common; if the doctor is writing too many prescriptions for pain medicine there is a chance their records will be audited.  That's why it may be a good idea to see a specialist for your particular diagnosis since specialists have more wiggle room in prescribing pain meds.

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